ERJ Open Research最新文献

{"title":"Prognostic factors after therapeutic bronchoscopy for tracheo- or broncho-oesophageal fistulas: results from the EpiGETIF registry.","authors":"Juliette Edme, Clément Fournier, Benoit Lepage, Claudia Zea Obando Ep Chateau, Laurent Cellerin, Frederic Wallyn, Gavin Plat, Valentin Héluain, Samy Lachkar, Thomas Egenod, Christophe Gut Gobert, Loic Perrot, Christine Lorut, Aurélie Lefebvre, Jean Michel Vergnon, Valerian Bourinet, Pascalin Roy, Julien Legodec, Hervé Dutau, Nicolas Guibert","doi":"10.1183/23120541.00435-2024","DOIUrl":"10.1183/23120541.00435-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of malignant tracheo- or broncho-oesophageal fistulas (TOF) using therapeutic bronchoscopy (TB) is not standardised and its outcomes are poorly described. This study aimed to analyse the characteristics of patients treated with TB for a TOF and to identify prognostic factors.</p><p><strong>Methods: </strong>We analysed data from 96 patients undergoing TB for TOF entered in the EpiGETIF registry between January 2019 and December 2022.</p><p><strong>Results: </strong>The mean age was 61.4 years. Median survival after TB was 2.40 months (95% CI 1.81-3.32). Histology was mainly represented by oesophageal (72%) and lung (23%) cancers and did not influence prognosis (p=0.15), whereas smoking did (2.17 <i>versus</i> 3.32 months for nonsmokers, p=0.04). Patients with poor <i>performance status</i> (Eastern Cooperative Oncology Group >2) had shorter survival (1.99 <i>versus</i> 3.02 months, p=0.04). 69% of patients had already received oncologic treatment, with no difference in survival (3.02 <i>versus</i> 2.21 months for treatment-naive patients, p=0.14). Neither the localisation (trachea 61.5%, left main bronchus 34.4%, other 4.1%) nor the size of the fistulas (23% <5 mm, 20% 5-10 mm, 54% >10 mm) impacted survival (p=0.91 and p=0.83, respectively). An airway stent (AS) was placed in 92.7% of patients, mainly self-expanding metallic stents (45%). Patients treated with both an oesophageal stent and AS had a better prognosis than patients treated with an AS alone (2.88 <i>versus</i> 1.77 months, respectively, p=0.02).</p><p><strong>Conclusion: </strong>Survival of patients treated with TB for a TOF is very poor, and is impacted by smoking, performance status and the presence of an oesophageal stent.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-inflammatory effects of tiotropium in COPD: a randomised double-blind trial.","authors":"Lisa H van Smoorenburg, Tatiana Karp, Benedikt Ditz, Wouter H van Geffen, Victor Guryev, Ali Almusa, Loes Kistemaker, Reinoud Gosens, Maarten van den Berge, Huib A M Kerstjens","doi":"10.1183/23120541.00735-2024","DOIUrl":"10.1183/23120541.00735-2024","url":null,"abstract":"<p><strong>Background: </strong>COPD is a major global health issue characterised by respiratory symptoms and exacerbations, significantly impacting mortality and quality of life. Muscarinic antagonists are known to prevent exacerbations, possibly by mitigating airway inflammation. This study evaluated the anti-inflammatory effects of tiotropium in patients with COPD by examining inflammatory protein profiles in sputum and blood, and genome-wide expression in sputum.</p><p><strong>Methods: </strong>We conducted the prospective, double-blind, randomised controlled ANTIOFLAM trial. Patients with COPD Global Initiative for Chronic Obstructive Lung Disease stage II or worse, aged ≥40 years and a smoking history of ≥10 pack-years were included. After a 4-week washout period of inhaled corticosteroids and anticholinergics, participants were randomised to 6 weeks of treatment with placebo or tiotropium (soft mist inhaler, 5 µg daily). Our primary end-point was a decrease of sputum interleukin (IL)-6 and IL-8 levels in the tiotropium group when compared to the placebo group.</p><p><strong>Results: </strong>We evaluated samples of 33 participants (n=17 placebo and n=16 tiotropium). Changes in sputum proteins IL-6 and IL-8 were significantly higher after treatment with tiotropium when compared to placebo (p<0.05). Differential expression analysis did not reveal gene expression differences including IL-6 and IL-8.</p><p><strong>Conclusion: </strong>We did not find tiotropium to have anti-inflammatory effects in sputum or blood of patients with COPD. In contrast, we found 6 weeks of treatment with tiotropium to increase the concentration of almost all tested sputum inflammatory proteins when compared to placebo, while RNA expression levels did not change.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-breath respiratory mechanics of prematurity-associated lung disease phenotypes in school-aged children.","authors":"Michael Cousins, Kylie Hart, Bence Radics, A John Henderson, Zoltán Hantos, Peter D Sly, Sailesh Kotecha","doi":"10.1183/23120541.00840-2024","DOIUrl":"10.1183/23120541.00840-2024","url":null,"abstract":"<p><strong>Background: </strong>Intra-breath oscillometry potentially offers detailed information regarding airway function, with increasing magnitude of difference between resistance and reactance at end-expiration to end-inspiration potentially associated with obstructive airway disease, but less is known about specific respiratory mechanics in preterm-born children using this methodology. We investigated whether different spirometry phenotypes of prematurity-associated lung disease (PLD) have specific intra-breath oscillometry features.</p><p><strong>Methods: </strong>167 school-aged (7-12 years) children, 14 with prematurity-associated obstructive lung disease (POLD; forced expiratory volume in 1 s (FEV₁) <lower limit of normal (LLN), FEV₁/forced vital capacity (FVC) <LLN), 11 with prematurity-associated preserved ratio impaired spirometry (pPRISm; FEV₁ <LLN, FEV₁/FVC ≥LLN), 90 preterm controls (FEV₁ ≥LLN) and 52 term controls, performed intra-breath oscillometry at baseline, following maximal cardiopulmonary exercise testing and following post-exercise bronchodilation.</p><p><strong>Results: </strong>Children with POLD showed greater resistance and more negative reactance throughout the respiratory cycle, including at zero-flow states of end-expiration and end-inspiration. The difference between end-expiration and end-inspiration did not show differences between groups until corrected for tidal volume, whereby children with POLD and pPRISm both demonstrated approximately two-fold greater difference compared to both preterm and term controls for resistance (2.24 and 2.22 <i>versus</i> 1.28 and 1.11 hPa·s·L^-1, respectively), and in particular a greater magnitude of difference for reactance for children with POLD <i>versus</i> preterm and term controls only (-1.58 <i>versus</i> -0.26 and 0.03 hPa·s·L^-1, respectively).</p><p><strong>Conclusions: </strong>Intra-breath respiratory mechanics for preterm-born children with an obstructive lung phenotype have greater impedance throughout the respiratory cycle, features different to those observed in children with other wheeze phenotypes including preschool wheeze and asthma.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing pulmonary arterial hypertension screening among <i>TBX4</i> mutation carriers: a timely endeavour.","authors":"David Montani, Julien Grynblat, Florence Coulet, Damien Bonnet, Antoine Beurnier, Marc Humbert","doi":"10.1183/23120541.00760-2024","DOIUrl":"10.1183/23120541.00760-2024","url":null,"abstract":"<p><p><b>Systematic genetic counselling for <i>TBX4</i> carriers and their relatives enables screening for small patella syndrome and early diagnosis of pulmonary arterial hypertension</b> https://bit.ly/4eKaPzY.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular-pulmonary arterial coupling predicts mortality in precapillary pulmonary hypertension.","authors":"Athiththan Yogeswaran, René Petermann, Nils C Kremer, Simon Schäfer, Zvonimir A Rako, Rebecca R Vanderpool, Ryan J Tedford, Khodr Tello","doi":"10.1183/23120541.00685-2024","DOIUrl":"10.1183/23120541.00685-2024","url":null,"abstract":"<p><p><b>RV-PA coupling, as reflected by the <i>E</i> _es/<i>E</i> _a ratio, holds substantial clinical relevance and augments the current prognostic assessment in patients with PAH and CTEPD with PH</b> https://bit.ly/4dyKPGJ.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mannitol-evoked cough response is reduced by inhaled salbutamol.","authors":"Mustafaa Wahab, Ruth P Cusack, Caitlin Stevens, Karen J Howie, Abbey Schlatman, Kieran J Killian, Paul M O'Byrne, Imran Satia, Gail M Gauvreau","doi":"10.1183/23120541.00815-2024","DOIUrl":"10.1183/23120541.00815-2024","url":null,"abstract":"<p><strong>Background: </strong>Mannitol inhalation induces bronchoconstriction and coughing in asthmatic patients. Salbutamol causes smooth muscle relaxation in acute asthma, but its effects on airway nerves are unclear. We conducted mannitol cough challenges in allergic asthmatic patients (AAs) and healthy controls (HCs) to determine whether salbutamol would reduce mannitol-evoked coughs independent of changes in airway calibre.</p><p><strong>Methods: </strong>A double-blind, randomised, placebo-controlled, two-way crossover study included 20 mild steroid-naïve AAs and 20 HCs. The maximum number of coughs (Emax) evoked by mannitol was compared between salbutamol and placebo.</p><p><strong>Results: </strong>HCs and AAs were matched for age, lung function and sex. Mannitol-evoked cough dose ratio (CDR) in HCs was significantly lower than in AAs (5.63±1.84 <i>versus</i> 7.32±3.67 coughs, p=0.023). Both groups had similar Emax, C2 and C5 (dose causing two and five coughs, respectively). In AAs mannitol decreased forced expiratory volume in 1 s (FEV₁) by 8.11±2.32% with placebo, which was attenuated to 3.19±1.16% with salbutamol (p=0.03). In HCs, FEV₁ reduction was not significant. Emax in AAs for placebo and salbutamol was 8.90 (8.09-9.80) coughs and 7.07 (6.28-8.00) coughs, respectively (p<0.001) and in HCs 8.19 (7.08-9.61) coughs and 4.95 (4.38-5.66) coughs, respectively (p<0.001). The effect of salbutamol on Emax between groups was significantly different (p<0.001). Salbutamol improved CDR, C2 and C5 in AAs (p<0.05) but without effect between groups.</p><p><strong>Conclusion: </strong>Salbutamol reduced mannitol Emax in AAs and HCs. The reduced mannitol-evoked cough response by salbutamol in HCs was independent of changes in airway calibre measured by FEV₁, suggesting mechanisms of salbutamol extend beyond smooth muscle relaxation.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating family dynamics and ethical considerations in genetic diagnosis of pulmonary arterial hypertension: insights from in-depth semi-structured interviews.","authors":"Emilia M Swietlik, Michaela Fay, Nicholas W Morrell","doi":"10.1183/23120541.00698-2024","DOIUrl":"10.1183/23120541.00698-2024","url":null,"abstract":"<p><strong>Background: </strong>Genetic diagnosis and precision medicine are rapidly advancing, driven by innovations in next-generation sequencing and omic methods. The UK's collaboration between national research initiatives and the National Health Service facilitates translation of research into clinical practice. This rapid transition impacts family dynamics and family planning, and raises ethical concerns, compounded by limited public and practitioner awareness of the long-term consequences of genetic diagnosis. Our objective is to explore the impact of genetic diagnosis on family dynamics and the ethical considerations of genetic testing at different life stages in patients with pulmonary arterial hypertension (PAH) and their at-risk relatives.</p><p><strong>Methods: </strong>Stakeholders from the National Institute for Health Research BioResource Rare Diseases Study and the National Cohort Study of Idiopathic and Heritable Pulmonary Arterial Hypertension were recruited using purposive sampling. 53 interviews and focus groups with 63 participants were recorded, transcribed and thematically analysed using MAXQDA data analysis software.</p><p><strong>Results: </strong>The study revealed three main themes: the impact of diagnosis on family dynamics, considerations for family planning, and genetic testing of relatives. Two attitudes toward testing offspring emerged: proactive advocates and gatekeepers. The gatekeeper stance was driven by three key factors: shielding children from genetic risk awareness, feelings of guilt or a desire to avoid blame for disease transmission, and limited family connections. Each theme highlighted various moral and ethical dilemmas faced by individuals.</p><p><strong>Conclusions: </strong>A PAH diagnosis reshapes family roles and responsibilities. Genetic risk awareness strengthens bonds but also introduces challenges such as disclosing information and deciding on testing for at-risk relatives. Our research highlights the need for comprehensive genetic counselling and support systems to enhance patient care and familial wellbeing.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis.","authors":"Christos Kyriakopoulos, Efthymia Papadopoulou, Dimitrios Potonos, Konstantinos Exarchos, Evangelos Beris, Christina Aggelopoulou, Stavros Tryfon, Athena Gogali, Konstantinos Kostikas","doi":"10.1183/23120541.00625-2024","DOIUrl":"10.1183/23120541.00625-2024","url":null,"abstract":"<p><strong>Background: </strong>Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma.</p><p><strong>Methods: </strong>We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials that assess the response to anti-IL-5/5Rα in real-life patients with severe eosinophilic asthma. We also performed random-effects meta-analyses.</p><p><strong>Results: </strong>We identified 6401 studies, of which 92 with 9546 patients were analysed. Biologics use was associated with a 62% reduction in severe exacerbations (risk ratio 0.38, 95% CI 0.29-0.50) and a 54% reduction in hospitalisations (risk ratio 0.46, 95% CI 0.35-0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control (decrease in asthma control questionnaire score by 1.11 points (95% CI -1.29--0.94) and increase in asthma control test score by 6.41 points (95% CI 5.66-7.16)) and increased the asthma quality of life questionnaire score by 1.08 points (95% CI 0.88-1.28) and forced expiratory volume in 1 s by 0.21 L (95% CI 0.15-0.27) at 12 months. There was a significant reduction in oral corticosteroids use of 51% (risk ratio 0.49, 95% CI 0.42-0.56), with a mean dose reduction of 6.01 mg·day^-1 (95% CI -7.55--4.48) at 12 months of treatment. Similar findings were observed at 3-4, 6 and 24 months. A biomarker-related response to treatment was also noted.</p><p><strong>Conclusions: </strong>This comprehensive meta-analysis summarises the significant clinical response to anti-IL-5/5Rα biologics in real-life studies, providing important insights for their use in clinical practice.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of smoke-free homes in 12 European countries: the TackSHS Survey.","authors":"Olena Tigova, Chiara Stival, Yolanda Castellano, Alessandra Lugo, Marcela Fu, Anna Mar López, Cristina Martínez, Joan B Soriano, Rachel O'Donnell, Sean Semple, Maria J López, Esteve Fernández, Silvano Gallus","doi":"10.1183/23120541.00950-2024","DOIUrl":"10.1183/23120541.00950-2024","url":null,"abstract":"<p><strong>Background: </strong>Homes are one of the primary locations where people are exposed to second-hand smoke (SHS) in Europe. We describe the prevalence and identify the main determinants of having home-smoking restrictions in 12 European countries.</p><p><strong>Methods: </strong>Cross-sectional survey in 12 European countries conducted in 2017-2018 (TackSHS project). Approximately 1000 participants representing the general population aged ≥15 years of each country were interviewed face to face. Individual- and country-level characteristics were explored through adjusted prevalence ratios (PRs) obtained from multilevel Poisson models with random effects.</p><p><strong>Results: </strong>Among 11 734 participants, 70.2% (95% confidence interval (CI) 69.4-71.0%) had smoke-free homes and 17.5% (95% CI 16.8-18.2%) had partial home-smoking restrictions in place. Prevalence of smoke-free homes ranged from 44.4% in Greece to 84.5% in England. Having a smoke-free home was significantly inversely associated with current (PR=0.60) or former (PR=0.95) smoking and living in a household with one (PR=0.70) or two or more (PR=0.58) people who smoke. It was also significantly associated with being ≥65 years old (PR=1.05), being female (PR=1.07), having a high educational level (PR=1.09) and living with children (PR=1.09). Having a smoke-free home was associated with living in northern Europe, while partial home-smoking restrictions were more likely among respondents from eastern Europe and countries with lower <i>per capita</i> gross domestic product.</p><p><strong>Conclusions: </strong>The prevalence of smoke-free homes in Europe is relatively high, but with large variability across countries. European countries with a lower prevalence of smoke-free homes should implement tailored interventions targeting identified determinants and incorporate the success of other countries.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised trial of assessing diagnostic yield in transbronchial biopsy with a guide sheath.","authors":"Hao-Chun Chang, Yao-Wen Kuo, Ching-Kai Lin, Lih-Chyun Chang, You-Yi Chen, Ching-Yao Yang, Jung-Yien Chien, Chia-Lin Hsu, Tzu-Hsiu Tsai, Chao-Chi Ho, Jin-Yuan Shih, Chong-Jen Yu","doi":"10.1183/23120541.00771-2024","DOIUrl":"10.1183/23120541.00771-2024","url":null,"abstract":"<p><strong>Objectives: </strong>Radial probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) with a guide sheath (GS) is widely used to diagnose peripheral lung lesions (PPLs), but there is no consensus on whether it increases the diagnostic yield. We conducted this prospective study to compare the diagnostic yield of the GS method to the conventional method without a GS.</p><p><strong>Methods: </strong>From November 2019 to March 2023, patients with PPLs were recruited and randomly assigned to rEBUS-TBB with a GS (GS group) or without a GS (conventional group). The histopathology, cytology and microbiology yield rates, as well as procedure time and post-procedure adverse events, of the two groups were compared.</p><p><strong>Results: </strong>A total of 102 patients were enrolled (54 in the GS group and 48 in the conventional group). The pathology yield showed no statistical difference between the two groups (75.9% <i>versus</i> 68.8%, p=0.418), while the yield rates of brushing cytology (64.3% <i>versus</i> 42.9%, p=0.030) and washing cytology (41.5% <i>versus</i> 20.0%, p=0.0443) were higher in the GS group. Meanwhile, the yield from GS washing culture was lower than the bronchial washing culture yield (0% <i>versus</i> 57.1%, p=0.017). The bleeding risk was also lower in the GS group (9.3% <i>versus</i> 20.8%, p=0.049).</p><p><strong>Conclusion: </strong>The pathology yield of rEBUS TBB with a GS did not significantly differ from the conventional method. However, a GS could improve the cytology yield rate and reduce the risk of bleeding. To enhance the microbiology yield, additional bronchial washing should be utilised.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}